Multivalent anthelminthic vaccine to prevent hookworm and schistosomiasis.

Hookworm infection and schistosomiasis are two of the world's most important human parasitic infections, affecting hundreds of millions of people in developing countries. Measured together in disability-adjusted life years, hookworm infection and schistosomiasis rank closely behind malaria as the most prevalent human parasitic diseases. A major approach for the control of these two helminth infections relies on periodic, mass chemotherapy with anthelminthics. However, high rates of post-treatment reinfection, the declining efficacy with repeated treatment, rebound morbidity (in the case of schistosomiasis) and the potential for the emergence of anthelminthic drug resistance threaten the sustainability of mass drug administration as the only form of control. Hence, there is a strong rationale for developing a vaccine that simultaneously targets both hookworms and schistosomes because of similarities in the pathobiology of both parasites, the ability of both helminths to cause anemia and their coendemicity in sub-Saharan Africa, Brazil and East Asia. A multivalent anthelminthic vaccine for hookworm infection and schistosomiasis would represent an important new tool for combating disease and poverty.